Extension of Permission /Approval for reimbursement of cost of Neuro-implants CGHS Beneficiaries/beneficiaries covered under CS(MA) Rules
Misc.12014/2005/CGHs(R&H)/CGHS (P)
Government of India
Ministry of Health and Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated the 4th December, 2008
OFFICE MEMORANDUM
Subject :-Extension of Permission /Approval for reimbursement of cost of Neuro-implants, viz., Deep Brain Stimulation implants, Intra-thecal Baclofen Pump, Intra-thecal Morphine Pump and Spinal Cord stimulators for CGHS Beneficiaries/beneficiaries covered under CS(MA) Rules.
The undersigned is directed to invite reference to the office Memorandum of even number dated the 23rd June,2006 on the above subject vide which rates for reimbursement towards the cost of neuro-implants were intimated and to state that it has now been decided to continue to allow the reimbursement of the cost of Neuro-implants, viz., Deep Brain Stimulation Implants, Intra-thecal Beclofen Pump, Intra-thecal Morphine Pump, spinal cord stimulators for CGHS beneficiaries/beneficiaries covered under CS(MA) rules. It has now been decided to allow reimbursement of cost of neuro-implants viz., Deep Brain stimulation implants, Intra-thecal Beclofen pump, Intra-thecal Morphine pump, spinal cord stimulators for CGHS beneficiaries/beneficiaries covered under CS(MA) rules, under the same terms and conditions, as was mentioned in the above referred office Memorandum of 23rd june 2006. viz:-
The prescribing Authority:-
DBS Implant: Neurologist of a Government Hospital
| Intra-thecal Beclofen Pump,
Intra-thecal Morphine Pump, Spinal Cord Stimulator |
Any two Govt. specialist of converned specialty/Head of Department of Neurology/ Neuro – Surgery/Anaesthesiology |
Approving Authority
* CGHS – Additional Director of the concerned CGHS city
* CS(MA) rules – DDG(M) or equivalent level officer of Directorate General of Health Services
Ceiling Rate
DBS Implant: Including MER
Rs.3,46,153/- + V.A.T Rs.13,847 – i.e Total of Rsl3,60,000/- (or actual, whichever is less)
Intra thecal Beclofan Pump, Intra thecal Morphine Pump
Rs.2,51,923/- + V.A.T.Rs.10.077 – i.e., Total of Rs.2,62,000/-
Spinal cord stimulator
Rs.2,51,923/- + V.A.T Rs.10,077 i.e., Total of Rs.2,62,000/-
Recurring expenditure on Beclofen/Morphine as per rules applicable for OPD medicines.
Life of Battery:
Life of Battery is 3-5 years in case of DBS implants and Spinal cord stimulator depending on parameters selected for stimulation and usage and up to 7 years in case of intra thecal infusion pump.
Cost of Battery for DBS Implant
Rs.2,40.385 + VAT Rs.9,615 i.e.Rs.2,50,000/- (or actual whichever is less)
Intra thecal Infusion Pump:
Rs.2,16,346 + VAT Rs.8,654 i.e. Rs.2,25,000/- (Or actual whichever is less)
Spinal Cord stimulator:
Rs.1.92.308 + VAT Rs.7692 i.e Rs.2,00,000/- (or actual, whichever is less)
Replacement of battery before 4 years may be permitted in exceptaional cases on the basis of justification by the treating specialist and shall be considered on a case to case basis by Department of Health & Family Welfare.
Guidelines:
1. DBS implant
The patient should be a case of idiopathic Parkinsonism resistant to conservative treatment.
The patient shall be informed in writing by treating specialist of the cost of implant and the efficacy of the treatment.
2. Intra thecal pumps/spinal cord stimulators
All conservative treatment procedures have failed and the diagnosis was confirmed.
Treating specialist shall certify that ther is reasonable chance of survival of terminally III patient
Therapeutic trials shall be conducted and recommendation should be based on pasitive therapeutic trials. The treating specialist shall certify as such in writing.
the patient shall be informed in writing by treating specialist of the cost of implant and the efficacy of the treatment.
Warranty:
the company offers limited warranty for two years from date of implantation to provide free replacement in the case of battery failure or if maffunctioning of the device is reported by the concerned physician.
the company shall also supply all the implants with not more than 1/6 of the life of battery exhausted.
Validity period of the ceilling rates:
These prices shall remain in force for a period of one year from the date of issue of this office Memorandum subject to the condition that any fall in prices in future in these products. the company would pass on the benefit to the CGHs beneficiary/CS (MA) beneficiary and the company shall charge the CGHS beneficiaries/beneficiaries covered under CS(MA) rules at lowered rates.
The company M/s India medtronic has claimed that the DBS Implant, synchromed Intrathcal Pump and spinal cord stumulator are proprietary items and has certified that the rates offered to CGHS are lowest and the company has not supplied to any other individual or organization at price lower thatn those quoted to CGHS in case of any change in the status the ceiling rate, conditions and proprietary status of the firm will then be reviewed by the CGHS.
This office memorandum is issued with the concurrence of Finance Division vide Dy.No.3001 dated the 21st November,2008.
(R.Ravi)
Deputy Secretary to Government of India
(Tel:2306 3483)